Advancing the detection of hearing loss in newborns through parallel genetic analysis

ABSTRACT

A newborn screening method is provided for detecting the causes of hereditary hearing loss. Patient specimen amplicons are synthesized, wherein the amplicon is an oligonucleotide specific to a gene selected from the group consisting of cytomegalovirus (CMV), mitochondria, and connexin 26 (Cx26). They are then spotted on a substrate and immobilized as a target for microarray production as wild type and mutated alleles are allowed to hybridize thereto and undergo image analysis.

SPECIFIC REFERENCE

[0001] This application hereby claims benefit of provisional application serial No. 60/370,762, having a filing date of May 28, 2002.

GOVERNMENT RIGHTS

[0002] This invention was made with the United States Government support under Grant No. 1R44DC04902-01 from the NIH. The United States Government has certain rights in this invention.

BACKGROUND

[0003] Profound sensorineural hearing loss affects at least 0.1% of the general newborn population, while an equal number are found to have lesser, but clinically significant degrees of hearing loss. This frequency is far higher than observed in disorders, such as PKU and congenital hypothyroidism, that are routinely screened for in the United States and other countries. It is now clearly established that auditory stimulation in the first six months of life is required to drive the development of normal speech and language. Sensory deprivation, due to hearing impairment, inhibits this development resulting in learning dysfunction, along with impaired social and emotional development.

[0004] Screening newborns for hearing loss using auditory methods is generally performed using a two tiered approach. In the first tier, newborns are screened using transient evoked otoacoustic emission (TEOAC). TEOAC measures sounds generated by the hair cells in the cochlea in response to acoustic stimulation. The sounds generated are indicative of the integrity of the inner ear. Those who fail TEOAC are referred for second tier audiometric testing using the more sensitive auditory brainstem response (ABR) assay. ABR is considered the standard for assessment of hearing in neonates and infants by measuring electroencephalographic waveforms in response to clicks. ABR assesses the outer, middle, and inner ear but also lower auditory pathways. The 2-tiered approach (TEOAC followed by ABR) to screening newborns for hearing loss via audiometric means is effective, however major caveats exist that reduce its overall sensitivity and specificity.

[0005] The logistics, associated with two-tiered auditory screening, results in many newborns being lost to follow-up. Newborns failing the TEOAC assay are required to return at a later date for ABR analysis. Studies have also indicated that 10-15% of newborns do not receive the first tier TEOAC assay due to early discharge and/or lack of tester time. While auditory testing is effective, short comings exist (e,g. test availability, logistics of 2^(nd) tier ABR analysis, sensitivity/specificity issues) and there is a clear need to improve the overall process. Owing to the widespread observance of common genetic abnormalities in connexin 26 gene and genes of mitochondrial origin, parallel genetic analysis holds great potential to improve screening for hearing loss. Screening newborns using molecular means to supplement auditory screening will provide critical data to confirm diagnosis of deafness in affected infants. Additionally, molecular genetic analysis has the added benefit of being able to identify infants who are at risk for late onset hearing loss that are currently missed by current audiologic screening programs.

[0006] Some infectious agents are responsible for hearing loss and the most common of these infectious agents that may cause hearing loss is cytomegalovirus. In the United States, approximately 1% of newborns are congenitally infected with the cytomegalovirus (CMV). A small minority of these infected newborns (10%) are symptomatic at birth (e.g. intrauterine growth retardation, hepatosplenogegaly, thrombocytopenia, intracranial calcifications), while the vast majority go unrecognized or diagnosis is delayed. Hearing loss attributable to CMV may be present at birth or develop postnatally. The severity of CMV induced hearing loss may vary from moderate to profound. Hearing loss associated with infection by CMV could be prevented by screening newborns for congenital CMV infection.

[0007] The majority of hereditary hearing loss (70%) is nonsyndromic, wherein the inner ear is the only body system affected. These nonsyndromic forms of hearing loss are particularly suited to prospective newborn screening because there may be no other overt clue to the presence of a hearing disorder. There are many genes involved in nonsyndromic hearing loss however genes of mitochondrial origin and connexin 26 (Cx26) account for the majority of hereditary deafness. In 1997 it was reported that mutations involving the Cx26 gene were the cause of hereditary deafness, owing to the DFNB 1 loci. In generic terms connexin describes a family of gap junction proteins that code for the membrane bound protein sub-units that line intercellular pores connecting adjacent cells and facilitate the movement of small molecules. Cx26 is a small gene with no introns and single exon of 798 base pairs. Connexin 26 is expressed in the cochlea and may contribute to regulation of potassium concentration in the cochlear endolymph. At least 21 pathologic mutations have been described, but one, the 35delG accounts for up to 70% of the observed mutations in many populations. Other high prevalence mutations include the 167del T which has a carrier frequency of about 4% in Ashkinazi Jews, 235delc found in many Asians, R143W that initially identified in Japanese but also identified frequently in Africans, and M34T which is widely distributed among diverse populations.

[0008] Techniques for DNA analysis have crossed a threshold of technical proficiency enabling population wide screening utilizing molecular genetic methods. In fact, for many years, gene level analysis has been performed using traditional methods such as electrophoresis, sequencing, or hybridization with an oligonucleotide probe. These methods are effective, however they are labor intensive and poorly amenable to automation and high throughput. A recent development for gene level analysis is the microarray. Microarrays are devices where minute quantities of DNA molecules are immobilized to an underlying substrate. High-density DNA microarrays are routinely fabricated with an excess of 100,000 distinct elements (synthetic DNA, PCR product, cDNA, etc) immobilized to defined sites in an array. Each site in the array identifies a unique genetic feature. Microarrays decipher complex gene expression patterns or analyze numerous diagnostic amplification products in a single assay. There is a need then for a newborn screening method for detecting the causes of hereditary hearing loss utilizing microarray technology and an oligonucleotide panel specific for hereditary hearing loss.

SUMMARY OF THE INVENTION

[0009] Accordingly, what is provided is a genetic screening method to detect the most common causes of hereditary hearing loss comprising the steps of synthesizing (using polymerase chain reaction) a patient specimen amplicon, wherein the amplicon consists of a section of the selected gene and contains the genetic site of interest; printing the amplicon on a substrate, thereby forming an immobilized target; querying the immobilized targets for genotype assignment by hybridization to a fluorescent-labeled probe, wherein the probe (defined by nucleotide sequence) is specific to a wild type or mutant allele complement to the target; thereby forming a hybridized microarray; scanning the microarray, thereby forming an image file of illuminated spots; and analyzing the image file by visual detection of and/or measurement of the amount and color of florescence in each spot. Through analysis of fluorescence intensity and color, the genotype of the specimen at those genetic sites of interest is determined.

BRIEF DESCRIPTION OF THE DRAWING

[0010] The patent or application file contains at least one drawing executed in color. Copies of this patent or patent application publication with color drawing(s) will be provided by the Office upon request and payment of the necessary fee.

[0011]FIG. 1 shows an example of a colored image file produced by the present invention.

DETAILED DESCRIPTION OF THE INVENTION

[0012] A “primer” is a short piece of synthetic single strand DNA complementary to a given DNA sequence and which acts as the initiation point from which replication proceeds via DNA polymerase.

[0013] “PCR” (polymerase chain reaction) as used herein and as generally known in the art is the rapid technique for amplification of a DNA or RNA sequence, wherein the oligonucleotide primers are annealed (form complimentary base pairing) to single stranded nucleotide sequences, which are copied by DNA polymerase replication.

[0014] “Hybridization” defines the process for annealing the complementary sequence through base pairing interaction between a probe and template.

[0015] “Target” is the tethered amplicon immobilized to the glass substrate of the microarray that is then available to accept the probe (complementary strand) through hybridization.

[0016] “Amplicons” refer to any DNA sequence prepared using polymerase chain reaction.

[0017] “Microarray” as defined herein is a specialized glass substrate to which amplicons are immobilized and as such are available to be hybridized with labeled probes and undergo image analysis to reveal differences in hybridization patterns. These differences in hybridization patterns are used for genotype assignment.

[0018] The oligonucleotide panel described herein includes strands of cytomegalovirus (CMV), connexin 26 (Cx26), and mitochondrial DNA for providing a complete microarray protocol for detecting the causes of hereditary hearing loss owing to the commonly observed genetic abnormalities occurring in these genes.

[0019] Connexins are a family of gap junction proteins that code for the membrane bound protein subunits that line intercellular pores connecting adjacent cells and facilitates the movement of small molecules. Cx26 is a small gene with no introns and a single exon of 798 base pairs. The sequence of the connexin 26 gene is shown as SEQUENCE ID NO: 1.

[0020] In the present invention, multiple mutations of the Cx26 gene are described as being indicators for hereditary hearing loss and are detected by using primers to amplify more than one designated portion of the gene. These gene fragments are subsequently immobilized on a glass substrate where they are queried for genotype designation using complementary probes. In the preferred embodiment of the present invention, four mutations on the Cx26 gene, plus the mutations/strands described below, are adapted to be detected simultaneously by determining an amount of fluorescence revealed after an image scan takes place when the probes are allowed to hybridize with each target amplicon. The Cx26 mutations include: 35 del., Cx26 167 del., Cx26 235 del., and Cx26 M34T, wherein the M is methionine encoded by ATG and the T is the threonine encoded by ACG.

[0021] Mitochondria also contain RNA and DNA, the means of which they independently replicate and code for the synthesis of some proteins, and nonsyndromic hearing loss can be caused by mutations to mitochondrial genes. The human mitochondrial genome contains about 16,567 nucleotide pairs and a sequence of which is designated herein as SEQ ID NO: 18. The multiple mutation panel as described herein includes the two mitochondrial mutations A1555G and A7445C. Mitochondrial mutations account for 8-25% of non-syndromic sensorineural hearing loss in some populations.

[0022] Cytomegalovirus (CMV) is an etiological agent that may cause hearing loss, completing the panel for hearing loss of the present invention. CMV is a member of the Herpesviridae family of large DNA viruses. Approximately 1% of all newborns are congenitally infected with CMV. Approximately half of the infants with symptomatic and 15% of infants with asymptomatic congenital CMV infection will present with hearing loss. A portion of a herpes virus sequence containing the relevant sequences that indicate the presence of CMV is set forth by SEQ ID NO: 27.

[0023] In accordance with the present invention, genomic DNA of known hereditary hearing loss (HHL) genotypes is extracted and purified. Genomic samples are collected from any traditional methods, such as from any tissue or organ from which RNA or DNA can be amplified, or by purification from a dried blood spot. In the current embodiment, DNA is extracted from a punch spot of a dried blood spot specimen retrieved from a filter paper card.

[0024] Primer design software is used to design the primers for the synthesis of patient specimen amplicons. Synthesis of the specimens is accomplished by PCR. In this embodiment, primers are designed such that Tm's fall within a 4.5° C. window centering around 61.0° C. This enables the use of common amplification conditions for all primer pairs. Table 1 below shows the primers developed for the current assay. TABLE 1 Primer Sequence ID No. Cx26 Fwd 5′ ATGGATTGGGGCACGCTG 3′ 2 35 Del. Cx26 Rev 5′ C6-CAATGCTGGTGGAGTGTTTGT 3′ 3 35 Del. Cx26 Fwd 5′ CCGACTTTGTCTGCAACACC 3′ 6 167 Del. Cx26 Rev 5′ C6-GTGATCGTAGCACACGTTCTTGC 3′ 7 167 Del. Cx26 Fwd 5′ CCCCATCTCCCACATCCG 3′ 10 235 Del. Cx26 Rev 5′ C6-CGCTGGGCTGGACACGAAG 3′ 11 235 Del. Cx26 Fwd 5′ CCGTCCTCTTCATTTTTCGC 3′ 14 M34T Cx26 Rev 5′ C6-TCTCCCCACACCTCCTTTGC 3′ 15 M34T Mito. Fwd 5′ CCCCTACGCATTTATATAGAGGA 3′ 19 A1555G Mito. Rev 5′ C6-CGTCCAAGTGCACTTTCCAGTAC 3′ 20 A1555G Mito. Fwd 5′ CCCACCCTACCACACATTCG 3′ 23 A7445C Mito. Rev 5′ C6-GGGGGTTCGATTCCTTCCT 3′ 24 A7445C CMV Fwd 5′ TTTGTTGTAAATGGCCGAGAGA 3′ 28 CMV Rev 5′ C6-CAACGGCGCACCCTAGAG 3′ 29

[0025] A C6 amino modifier is attached to the 5′ end of the primer. The modifier group enables the attachment and isolation of the specific strand to the glass substrate used for microarray printing. For each PCR primer set, one or both primers have the C6 amino modifier. By doing this, only the one strand of the amplicon will attach to the glass slide, the other strand will be washed away during the slide processing steps which are performed after printing. Selection of a particular strand acts to enhance the hybridization efficiency by eliminating binding competition between the complementary amplicon strand and the assay probe for the target.

[0026] The amplicon is then spotted on the glass substrate and readied for hybridization. Fluorescent dye-labeled oligonucleotide probes matched to either wild type or mutant alleles were designed as indicated in table 2 below.

[0027] Hybridization is the process of incubating the immobilized target DNA tethered on the glass substrate with the labeled probe DNA at a particular temperature. The fluorescent probe DNA will hybridize with the primer-amplified, target DNA and the amount of immobilized fluorescence can be determined by a scan.

[0028] Each spot of DNA contains pixels, which are illuminated one pixel at a time using lasers until all the spots on the DNA chip have been scanned and recorded as a high-resolution image file. The scanned images are analyzed in an automated data extraction process that measures the absolute and relative fluorescence at two wavelengths. The use of the present targets and probes for DNA microarray analysis produces the hybridized microarray slide images as seen in FIG. 1, specific for detecting the causes of hereditary hearing loss.

EXAMPLE

[0029] Samples and DNA Preparation

[0030] Genomic DNA of known HHL genotypes (Wild Type, Heterozygous, and Homozygous) were purified from Guthrie filter card Dried Blood Spots. DNA is extracted from a 3.2 mm punch of DBS.

[0031] PCR Amplification

[0032] Synthesis of patient specimen amplicons is accomplished by PCR. Primer Premier 5.0 and Oligo 6.0 are among the most advanced PCR primer design software packages and are both employed for primer design. Primers are designed such that Tm's fall within a 4.5° C. window centering around 61.0° C. This enables the use of common amplification conditions for all primer pairs.

[0033] All primers are synthesized and HPLC purified by Operon Technologies, Inc. (Alameda, Calif.). A C6 amino modifier is attached to the 5′ end of selected primers to enable the attachment and isolation of a specific strand to the glass substrate used for microarray printing. For each PCR primer set, only one primer has the C6 amino modifier. By doing this, only the one strand of the amplicon will be attached to the glass substrate, the other strand will be washed away during the processing step. Selection of a particular strand acts to enhance the hybridization efficiency by eliminating competition between the complementary amplicon strand and the assay probe for target binding.

[0034] The PCR amplification reaction (10 μl) contained 10 mM Tris-HCl; 1.5 mM MgCl₂; 50 mM KCl; 4 μl DNA; 0.5 μM each of primers; 200 μM each of dATP, dCTP, dGTP, and dTTP; 0.08 μg TaqStart Antibody (CloneTech); 0.4 unit Taq Polymerase (Roche). PCR was performed in a MWG Biotech PrimusHT Multibloack thermal cycler. Cycling condition are one cycle at 94° C. for 20 sec, 58° C. for 30 sec, 72° C. for 20 sec, and a final cycle at 72° C. for 2 min.

[0035] MicroArray Printing and Processing

[0036] There is no PCR purification needed after the PCR reactions are completed. Ten μl of sodium phosphate spotting buffer (300 mM sodium phosphate, pH 8.5/0.02% SDS) was added to each 10 ul PCR reaction, and then printed onto Eppendorf's CreativeChip Oligo slides(Hamburg, Germany) using Virtek Vision's ChipWriter Professional Arrayer (Waterloo, ON, Canada). Printed slides were incubated at 50° C. for 1 hour in a humidified chamber, baked at 80° C. for 1 hour, incubated with 200 ml boiled dH₂O for 3 min, then dried by centrifigation.

[0037] Hybridization

[0038] Fluorescent dye-labeled oligonucleotide probes matched to either wild type or mutant alleles were designed as indicated in table II, and synthesized. All probes were analyzed by spectrophotometry for oligonucleotide and fluorophore concentration. The Hybridization solution contains Quantifoil's QMT Hybridization buffer (Jena, Germany) with both wild type and mutant probes at a final concentration of 0.1 μM. Each hybridization reaction was carried out with 20 μl of hybridization solution added to the printed slides, covered with a glass coverslip, sealed in the hybridization cassette with 50 μl of dH₂O added to the humidity control chamber. The cassette was then put into a circulated water bath, incubated at 50° C. for 1 hour. After 1 hour incubation, the slide was taken out of the cassette and the coverslip was removed. Excess probe is immediately rinsed from the slide by dipping the slide into a room temperature solution of 2×SSC, 0.1% sarcosyl. Non-specific probe binding is then washed from the slide by placing the slide into a container of 2×SSC, 0.1% sarcosyl and incubated in this solution at 50° C. for 10′. The slides are then further washed by dipping 2 to 3 times in a room temperature solution of 2×SSC followed by dipping 2 to 3 times in a room temperature solution of 0.2×SSC. The slide is then immediately dried by centrifugation for 3′ at room temperature.

[0039] Microarray Scanning

[0040] Each hybridized microarray slide was scanned with Virtek Vision's ChipReader scanner. For both Cy3 and Cy5 channel of the scanner, laser power was set at 100, detector gain at 1, and the number of scans at 1, and detector sensitivity t 1000.

[0041] Image Composite

[0042] The two images from scanning of each microarray slide was composited with ArrayPro Analyzer (Media Cybernetics, L. P.)

[0043] Methods of Data Analysis and Interpretation

[0044] The resulting data may be analyzed using a variety of approaches. For the purposes of the present invention, two examples are herein described, though others may be readily apparent to those of ordinary skill in the art. The first approach is by visual inspection of the resulting wild type and mutant signal composite image as described below. Since the wild type and the mutant probes are labeled with different fluorophors, each will emit light at a different wavelength. When the slide is scanned at each of these two wavelengths, two images are created. One image corresponds to the wild type probe signal and the other image corresponds to the mutant probe signal. After the images are acquired, analysis software is used to assign each image a specific color. One color will be assigned to the signal resulting from the wild type probe and another color will be assigned to the signal resulting from the mutant probe. When the two images (wild type and mutant) are combined into a single composite image, all possible genotypes, including samples containing any combination of the mutant and wild type alleles (heterozygotes), can be visually detected. This visual detection is possible because samples containing a combination of wild type or mutant alleles will composite to produce additional computer generated colors which will differ from the colors originally assigned to the wild type and mutant alleles. One will only need to visually determine the sample image color to determine the sample genotype.

[0045] A second analysis approach is used to assign quantitative values to each genotype. In this approach, the slides are probed with both wild type and mutant probes of differing fluorophor emission wavelengths as in the above approach. Also as above, the slide is scanned and a separate image is created for the mutant signal and the wild type signal. From this point, the signal from each of the images is quantified using array analysis software. For each sample, a ratio of wild type to mutant signal is calculated. The resulting quantitative ratios can then be categorized into distinct value ranges for each of the possible genotypes. All of this quantification is performed by computer analysis, genotypes are computer assigned, and results are outputted for easy and rapid interpretation in a high-through-put screening laboratory.

1 30 1 2311 DNA Homo sapiens 1 gatttaatcc tatgacaaac taagttggtt ctgtcttcac ctgttttggt gaggttgtgt 60 aagagttggt gtttgctcag gaagagattt aagcatgctt gcttacccag actcagagaa 120 gtctccctgt tctgtcctag ctatgttcct gtgttgtgtg cattcgtctt ttccagagca 180 aaccgcccag agtagaagat ggattggggc acgctgcaga cgatcctggg gggtgtgaac 240 aaacactcca ccagcattgg aaagatctgg ctcaccgtcc tcttcatttt tcgcattatg 300 atcctcgttg tggctgcaaa ggaggtgtgg ggagatgagc aggccgactt tgtctgcaac 360 accctgcagc caggctgcaa gaacgtgtgc tacgatcact acttccccat ctcccacatc 420 cggctatggg ccctgcagct gatcttcgtg tccagcccag cgctcctagt ggccatgcac 480 gtggcctacc ggagacatga gaagaagagg aagttcatca agggggagat aaagagtgaa 540 tttaaggaca tcgaggagat caaaacccag aaggtccgca tcgaaggctc cctgtggtgg 600 acctacacaa gcagcatctt cttccgggtc atcttcgaag ccgccttcat gtacgtcttc 660 tatgtcatgt acgacggctt ctccatgcag cggctggtga agtgcaacgc ctggccttgt 720 cccaacactg tggactgctt tgtgtcccgg cccacggaga agactgtctt cacagtgttc 780 atgattgcag tgtctggaat ttgcatcctg ctgaatgtca ctgaattgtg ttatttgcta 840 attagatatt gttctgggaa gtcaaaaaag ccagtttaac gcattgccca gttgttagat 900 taagaaatag acagcatgag agggatgagg caacccgtgc tcagctgtca aggctcagtc 960 gccagcattt cccaacacaa agattctgac cttaaatgca accatttgaa acccctgtag 1020 gcctcaggtg aaactccaga tgccacaatg agctctgctc ccctaaagcc tcaaaacaaa 1080 ggcctaattc tatgcctgtc ttaattttct ttcacttaag ttagttccac tgagacccca 1140 ggctgttagg ggttattggt gtaaggtact ttcatatttt aaacagagga tatcggcatt 1200 tgtttctttc tctgaggaca agagaaaaaa gccaggttcc acagaggaca cagagaaggt 1260 ttgggtgtcc tcctggggtt ctttttgcca actttcccca cgttaaaggt gaacattggt 1320 tctttcattt gctttggaag ttttaatctc taacagtgga caaagttacc agtgccttaa 1380 actctgttac actttttgga agtgaaaact ttgtagtatg ataggttatt ttgatgtaaa 1440 gatgttctgg ataccattat atgttccccc tgtttcagag gctcagattg taatatgtaa 1500 atggtatgtc attcgctact atgatttaat ttgaaatatg gtcttttggt tatgaatact 1560 ttgcagcaca gctgagagag gctgtctgtt gtattcattg tggtcatagc acctaacaac 1620 attgtagcct caatcgagtg agacagacta gaagttccta gttggcttat gatagcaaat 1680 ggcctcatgt caaatattag atgtaatttt gtgtaagaaa tacagactgg atgtaccacc 1740 aactactacc tgtaatgaca ggcctgtcca acacatctcc cttttccatg ctgtggtagc 1800 cagcatcgga aagaacgctg atttaaagag gtgagcttgg gaattttatt gacacagtac 1860 catttaatgg ggagacaaaa atgggggcca ggggagggag aagtttctgt cgttaaaaac 1920 gagtttggaa agactggact ctaaattctg ttgattaaag atgagctttg tctaccttca 1980 aaagtttgtt tggcttaccc ccttcagcct ccaatttttt aagtgaaaat ataactaata 2040 acatgtgaaa agaatagaag ctaaggttta gataaatatt gagcagatct ataggaagat 2100 tgaacctgaa tattgccatt atgcttgaca tggtttccaa aaaatggtac tccacatact 2160 tcagtgaggg taagtatttt cctgttgtca agaatagcat tgtaaaagca ttttgtaata 2220 ataaagaata gctttaatga tatgcttgta actaaaataa ttttgtaatg tatcaaatac 2280 atttaaaaca ttaaaatata atctctataa t 2311 2 18 DNA Homo sapiens 2 atggattggg gcacgctg 18 3 21 DNA Homo sapiens 3 caatgctggt ggagtgtttg t 21 4 15 DNA Homo sapiens 4 tcctgggggg tgtga 15 5 15 DNA Homo sapiens 5 ttcctggggg tgtga 15 6 20 DNA Homo sapiens 6 ccgactttgt ctgcaacacc 20 7 23 DNA Homo sapiens 7 grgatcgtag cacacgttct tgc 23 8 15 DNA Homo sapiens 8 acaccctgca gccag 15 9 15 DNA Homo sapiens 9 tacacccgca gccag 15 10 18 DNA Homo sapiens 10 ccccatctcc cacatccg 18 11 19 DNA Homo sapiens 11 cgctgggctg gacacgaag 19 12 15 DNA Homo sapiens 12 ggccctgcag ctgat 15 13 15 DNA Homo sapiens 13 ggcctgcagc tgatc 15 14 20 DNA Homo sapiens 14 ccgtcctctt catttttcgc 20 15 20 DNA Homo sapiens 15 tctccccaca cctcctttgc 20 16 16 DNA Homo sapiens 16 cgaggatcat aatgcg 16 17 16 DNA Homo sapiens 17 cgcattacga tcctcg 16 18 16567 DNA Homo sapiens misc_feature (3040)..(3040) n is a, c, g, or t 18 gatcacaggt ctatcaccct attaaccact cacgggagct ctccatgcat ttggtatttt 60 cgtctggggg gtgtgcacgc gatagcattg cgagacgctg gagccggagc accctatgtc 120 gcagtatctg tctttgattc ctgcctcatc ctattattta tcgcacctac gttcaatatt 180 acaggcgaac atacttacta aagtgtgtta attaattaat gcttgtagga cataataata 240 acaattgatg tctgcacagc cgctttccac acagacatca taacaaaaaa tttccaccaa 300 acccccccct ccccccgctt ctggccacag cacttaaaca catctctgcc aaaccccaaa 360 aacaaagaac cctaacacca gcctaaccag atttcaaatt ttatcttttg gcggtatgca 420 cttttaacag tcacccccca actaacacat tattttcccc tcccactccc atactactaa 480 tctcatcaat acaacccccg cccatcctac ccagcacaca caccgctgct aaccccatac 540 cccgaaccaa ccaaacccca aagacacccc ccacagttta tgtagcttac ctcctcaaag 600 caatacactg aaaatgttta gacgggctca catcacccca taaacaaata ggtttggtcc 660 tagcctttct attagctctt agtaagatta cacatgcaag catccccgtt ccagtgagtt 720 caccctctaa atcaccacga tcaaaaggga caagcatcaa gcacgcagca atgcagctca 780 aaacgcttag cctagccaca cccccacggg aaacagcagt gattaacctt tagcaataaa 840 cgaaagttta actaagctat actaacccca gggttggtca atttcgtgcc agccaccgcg 900 gtcacacgat taacccaagt caatagaagc cggcgtaaag agtgttttag atcaccccct 960 ccccaataaa gctaaaactc acctgagttg taaaaaactc cagttgacac aaaatagact 1020 acgaaagtgg ctttaacata tctgaacaca caatagctaa gacccaaact gggattagat 1080 accccactat gcttagccct aaacctcaac agttaaatca acaaaactgc tcgccagaac 1140 actacgagcc acagcttaaa actcaaagga cctggcggtg cttcatatcc ctctagagga 1200 gcctgttctg taatcgataa accccgatca acctcaccac ctcttgctca gcctatatac 1260 cgccatcttc agcaaaccct gatgaaggct acaaagtaag cgcaagtacc cacgtaaaga 1320 cgttaggtca aggtgtagcc catgaggtgg caagaaatgg gctacatttt ctaccccaga 1380 aaactacgat agcccttatg aaacttaagg gtcgaaggtg gatttagcag taaactgaga 1440 gtagagtgct tagttgaaca gggccctgaa gcgcgtacac accgcccgtc accctcctca 1500 agtatacttc aaaggacatt taactaaaac ccctacgcat ttatatagag gagacaagtc 1560 gtaacatggt aagtgtactg gaaagtgcac ttggacgaac cagagtgtag cttaacacaa 1620 agcacccaac ttacacttag gagatttcaa cttaacttga ccgctctgag ctaaacctag 1680 ccccaaaccc actccacctt actaccagac aaccttagcc aaaccattta cccaaataaa 1740 gtataggcga tagaaattga aacctggcgc aatagatata gtaccgcaag ggaaagatga 1800 aaaattataa ccaagcataa tatagcaagg actaacccct ataccttctg cataatgaat 1860 taactagaaa taactttgca aggagagcca aagctaagac ccccgaaacc agacgagcta 1920 cctaagaaca gctaaaagag cacacccgtc tatgtagcaa aatagtggga agatttatag 1980 gtagaggcga caaacctacc gagcctggtg atagctggtt gtccaagata gaatcttagt 2040 tcaactttaa atttgcccac agaaccctct aaatcccctt gtaaatttaa ctgttagtcc 2100 aaagaggaac agctctttgg acactaggaa aaaaccttgt agagagagta aaaaatttaa 2160 cacccatagt aggcctaaaa gcagccacca attaagaaag cgttcaagct caacacccac 2220 tacctaaaaa atcccaaaca tataactgaa ctcctcacac ccaattggac caatctatca 2280 ccctatagaa gaactaatgt tagtataagt aacatgaaaa cattctcctc cgcataagcc 2340 tgcgtcagat taaaacactg aactgacaat taacagccca atatctacaa tcaaccaaca 2400 agtcattatt accctcactg tcaacccaac acaggcatgc tcataaggaa aggttaaaaa 2460 aagtaaaagg aactcggcaa atcttacccc gcctgtttac caaaaacatc acctctagca 2520 tcaccagtat tagaggcacc gcctgcccag tgacacatgt ttaacggccg cggtacccta 2580 accgtgcaaa ggtagcataa tcacttgttc cttaaatagg gacctgtatg aatggctcca 2640 cgagggttca gctgtctctt acttttaacc agtgaaattg acctgcccgt gaagaggcgg 2700 gcatgacaca gcaagacgag aagaccctat ggagctttaa tttattaatg caaacagtac 2760 ctaacaaacc cacaggtcct aaactaccaa acctgcatta aaaatttcgg ttggggcgac 2820 ctcggagcag aacccaacct ccgagcagta catgctaaga cttcaccagt caaagcgaac 2880 tactatactc aattgatcca ataacttgac caacggaaca agttacccta gggataacag 2940 cgcaatccta ttctagagtc catatcaaca atagggttta cgacctcgat gttggatcag 3000 gacatcccga tggtgcagcc gctattaaag gttcgtttgn tcaacgatta aagtcctacg 3060 tgatctgagt tcagaccgga gtaatccagg tcggtttcta tctacttcaa attcctccct 3120 gtacgaaagg acaagagaaa taaggcctac ttcacaaagc gccttccccc gtaaatgata 3180 tcatctcaac ttagtattat acccacaccc acccaagaac agggtttgtt aagatggcag 3240 agcccggtaa tcgcataaaa cttaaaactt tacagtcaga ggttcaattc ctcttcttaa 3300 caacataccc atggccaacc tcctactcct cattgtaccc attctaatcg caatggcatt 3360 cctaatgctt accgaacgaa aaattctagg ctatatacaa ctacgcaaag gccccaacgt 3420 tgtaggcccc tacgggctac tacaaccctt cgctgacgcc ataaaactct tcaccaaaga 3480 gcccctaaaa cccgccacat ctaccatcac cctctacatc accgccccga ccttagctct 3540 caccatcgct cttctactat gaacccccct ccccataccc aaccccctgg tcaacctcaa 3600 cctaggcctc ctatttattc tagccacctc tagcctagcc gtttactcaa tcctctgatc 3660 agggtgagca tcaaactcaa actacgccct gatcggcgca ctgcgagcag tagcccaaac 3720 aatctcatat gaagtcaccc tagccatcat tctactatca acattactaa taagtggctc 3780 ctttaacctc tccaccctta tcacaacaca agaacacctc tgattactcc tgccatcatg 3840 acccttggcc ataatatgat ttatctccac actagcagag accaaccgaa cccccttcga 3900 ccttgccgaa ggggagtccg aactagtctc aggcttcaac atcgaatacg ccgcaggccc 3960 cttcgcctta ttcttcatag ccgaatacac aaacattatt ataataaaca ccctcaccac 4020 tacaatcttc ctaggaacaa catatgacgc actctcccct gaactctaca caacatattt 4080 tgttaccaag accctacttc taacctccct gttcttatga attcgaacag catacccccg 4140 attccgctac gaccaactca tacacctcct atgaaaaaac ttcctaccac tcaccctagc 4200 attacttata tgatatgttt ccatacccat tacaatctcc agcattcccc ctcaaaccta 4260 agaaatatgt ctgataaaag agttactttg atagagtaaa taataggagc ttaaaccccc 4320 ttatttctag gactatgaga atcgaaccca tccctgagaa tccaaaattc tccgtgccac 4380 ctatcacacc ccatcctaaa gtaaggtcag ctaaataagc tatcgggccc ataccccgaa 4440 aatgttggtt atacccttcc cgtactaatt aatcccctgg cccaacccgt catctactct 4500 accatctttg caggcacact catcacagcg ctaagctcgc actgattttt tacctgagta 4560 ggcctagaaa taaacatgct agcttttatt ccagttctaa ccaaaaaaat aaaccctcgt 4620 tccacagaag ctgccatcaa gtatttcctc acgcaagcaa ccgcatccat aatccttcta 4680 atagctatcc tcttcaacaa tatactctcc ggacaatgaa ccataaccaa tactaccaat 4740 caatactcat cattaataat cataatggct atagcaataa aactaggaat agcccccttt 4800 cacttctgag tcccagaggt tacccaaggc acccctctga catccggcct gcttcttctc 4860 acatgacaaa aactagcccc catctcaatc atataccaaa tctctccctc actaaacgta 4920 agccttctcc tcactctctc aatcttatcc atcatagcag gcagttgagg tggattaaac 4980 caaacccagc tacgcaaaat cttagcatac tcctcaatta cccacatagg atgaataata 5040 gcagttctac cgtacaaccc taacataacc attcttaatt taactattta tattatccta 5100 actactaccg cattcctact actcaactta aactccagca ccacgaccct actactatct 5160 cgcacctgaa acaagctaac atgactaaca cccttaattc catccaccct cctctcccta 5220 ggaggcctgc ccccgctaac cggctttttg cccaaatggg ccattatcga agaattcaca 5280 aaaaacaata gcctcatcat ccccaccatc atagccacca tcaccctcct taacctctac 5340 ttctacctac gcctaatcta ctccacctca atcacactac tccccatatc taacaacgta 5400 aaaataaaat gacagtttga acatacaaaa cccaccccat tcctccccac actcatcgcc 5460 cttaccacgc tactcctacc tatctcccct tttatactaa taatcttata gaaatttagg 5520 ttaaatacag accaagagcc ttcaaagccc tcagtaagtt gcaatactta atttctgtaa 5580 cagctaagga ctgcaaaacc ccactctgca tcaactgaac gcaaatcagc cactttaatt 5640 aagctaagcc cttactagac caatgggact taaacccaca aacacttagt taacagctaa 5700 gcaccctaat caactggctt caatctactt ctcccgccgc cgggaaaaaa ggcgggagaa 5760 gccccggcag gtttgaagct gcttcttcga atttgcaatt caatatgaaa atcacctcgg 5820 agctggtaaa aagaggccta acccctgtct ttagatttac agtccaatgc ttcactcagc 5880 cattttacct cacccccact gatgttcgcc gaccgttgac tattctctac aaaccacaaa 5940 gacattggaa cactatacct attattcggc gcatgagctg gagtcctagg cacagctcta 6000 agcctcctta ttcgagccga gctgggtcag ccaggcaacc ttctaggtaa cgaccacatc 6060 tacaacgtta tcgtcacagc ccatgcattt gtaataatct tcttcatagt aatacccatc 6120 ataatcggag gctttggcaa ctgactagtt cccctaataa tcggtgcccc cgatatggcg 6180 tttccccgca taaacaacat aagcttctga ctcttacctc cctctctcct actcctgctc 6240 gcatctgcta tagtggaggc cggagcagga acaggttgaa cagtctaccc tcccttagca 6300 gggaactact cccaccctgg agcctccgta gacctaacca tcttctcctt acacctagca 6360 ggtgtctcct ctatcttagg ggccatcaac ttcatcacaa caattatcaa tataaaaccc 6420 cctgccataa cccaatacca aacgcccctc ttcgtctgat ccgtcctaat cacagcagtc 6480 ctacttctcc tatctctccc agtcctagct gctggcatca ctatactact aacagaccgc 6540 aacctcaaca ccaccttctt cgaccccgcc ggaggaggag accccattct ataccaacac 6600 ctattctgat ttttcggtca ccctgaagtt tatattctta tcctaccagg cttcggaata 6660 atctcccata ttgtaactta ctactccgga aaaaaagaac catttggata cataggtatg 6720 gtctgagcta tgatatcaat tggcttccta gggtttatcg tgtgagcaca ccatatattt 6780 acagtaggaa tagacgtaga cacacgagca tatttcacct ccgctaccat aatcatcgct 6840 atccccaccg gcgtcaaagt atttagctga ctcgccacac tccacggaag caatatgaaa 6900 tgatctgctg cagtgctctg agccctagga ttcatctttc ttttcaccgt aggtggccta 6960 actggcattg tattagcaaa ctcatcacta gacatcgtac tacacgacac gtactacgtt 7020 gtagctcact tccactatgt cctatcaata ggagctgtat ttgccatcat aggaggcttc 7080 attcactgat ttcccctatt ctcaggctac accctagacc aaacctacgc caaaatccat 7140 ttcactatca tattcatcgg cgtaaatcta actttcttcc cacaacactt tctcggccta 7200 tccggaatgc cccgacgtta ctcggactac cccgatgcat acaccacatg aaacatccta 7260 tcatctgtag gctcattcat ttctctaaca gcagtaatat taataatttt catgatttga 7320 gaagccttcg cttcgaagcg aaaagtccta atagtagaag aaccctccat aaacctggag 7380 tgactatatg gatgcccccc accctaccac acattcgaag aacccgtata cataaaatct 7440 agacaaaaaa ggaaggaatc gaacccccca aagctggttt caagccaacc ccatggcctc 7500 catgactttt tcaaaaaggt attagaaaaa ccatttcata actttgtcaa agttaaatta 7560 taggctaaat cctatatatc ttaatggcac atgcagcgca agtaggtcta caagacgcta 7620 cttcccctat catagaagag cttatcacct ttcatgatca cgccctcata atcattttcc 7680 ttatctgctt cctagtcctg tatgcccttt tcctaacact cacaacaaaa ctaactaata 7740 ctaacatctc agacgctcag gaaatagaaa ccgtctgaac tatcctgccc gccatcatcc 7800 tagtcctcat cgccctccca tccctacgca tcctttacat aacagacgag gtcaacgatc 7860 cctcccttac catcaaatca attggccacc aatggtactg aacctacgag tacaccgact 7920 acggcggact aatcttcaac tcctacatac ttcccccatt attcctagaa ccaggcgacc 7980 tgcgactcct tgacgttgac aatcgagtag tactcccgat tgaagccccc attcgtataa 8040 taattacatc acaagacgtc ttgcactcat gagctgtccc cacattaggc ttaaaaacag 8100 atgcaattcc cggacgtcta aaccaaacca ctttcaccgt tacacggccg ggggtatact 8160 acggtcaatg ctctgaaatc tgtggagcaa accacagttt catgcccatc gtcctagaat 8220 taattcccct aaaaatcttt gaaatagggc ccgtatttac cctatagcac cccctctacc 8280 ccccctagag cccactgtaa agctaactta gcattaacct tttaagttaa agattaagag 8340 aaccaacacc tctttacagt gaaatgcccc aactaaatac taccgtatgg cccaccataa 8400 ttacccccat actccttaca ctattcctca tcacccaact aaaaatatta aacacaaact 8460 accacctacc tccctcacca aagcccataa aaataaaaaa ttataacaaa ccctgagaac 8520 caaaatgaac gaaaatctgt tcgcttcatt cattgccccc acaatcctag gcctacccgc 8580 cgcagtactg atcattctat ttccccctct attgatcccc acctccaaat atctcatcaa 8640 caaccgacta atcaccaccc aacaatgact aatcaaacta acctcaaaac aaatgataac 8700 catacacaac actaaaggac gaacctgatc tcttatacta gtatccttaa tcatttttat 8760 tgccacaact aacctcctcg gactcctgcc tcactcattt acaccaacca cccaactatc 8820 tataaaccta gccatggcca tccccttatg agcgggcgca gtgattatag gctttcgctc 8880 taagattaaa aatgccctag cccacttctt accacaaggc acacctacac cccttatccc 8940 catactagtt attatcgaaa ccatcagcct actcattcaa ccaatagccc tggccgtacg 9000 cctaaccgct aacattactg caggccacct actcatgcac ctaattggaa acgccaccct 9060 agcaatatca accattaacc ttccctctac acttatcatc ttcacaattc taattctact 9120 gactatccta gaaatcgctg tcgccttaat ccaagcctac gttttcacac ttctagtaag 9180 cctctacctg cacgacaaca cataatgacc caccaatcac atgcctatca tatagtaaaa 9240 cccagcccat gacccctaac aggggccctc tcagccctcc taatgacctc cggcctagcc 9300 atgtgatttc acttccactc cataacgctc ctcatactag gcctactaac caacacacta 9360 accatatacc aatgatggcg cgatgtaaca cgagaaagca cataccaagg ccaccacaca 9420 ccacctgtcc aaaaaggcct tcgatacggg ataatcctat ttattacctc agaagttttt 9480 ttcttcgcag gatttttctg agccttttac cactccagcc tagcccctac cccccaatta 9540 ggaggacact ggcccccaac aggcatcacc ccgctaaatc ccctagaagt cccactccta 9600 aacacatccg tattactcgc atcaggagta tcaatcacct gagctcacca tagtctaata 9660 gaaaacaacc gaaaccaaat aattcaagca ctgcttatta caattttact gggtctctat 9720 tttaccctcc tacaagcctc agagtacttc gagtctccct tcaccatttc cgacggcatc 9780 tacggctcaa cattttttgt agccacaggc ttccacggac ttcacgtcat tattggctca 9840 actttcctca ctatctgctt catccgccaa ctaatatttc actttacatc caaacatcac 9900 tttggcttcg aagccgccgc ctgatactgg cattttgtag atgtggtttg actatttctg 9960 tatgtctcca tctattgatg agggtcttac tcttttagta taaatagtac cgttaacttc 10020 caattaacta gttttgacaa cattcaaaaa agagtaataa acttcgcctt aattttaata 10080 atcaacaccc tcctagcctt actactaata attattacat tttgactacc acaactcaac 10140 ggctacatag aaaaatccac cccttacgag tgcggcttcg accctatatc ccccgcccgc 10200 gtccctttct ccataaaatt cttcttagta gctattacct tcttattatt tgatctagaa 10260 attgccctcc ttttacccct accatgagcc ctacaaacaa ctaacctacc actaatagtt 10320 atgtcatccc tcttattaat catcatccta gccctaagtc tggcctatga gtgactacaa 10380 aaaggattag actgaaccga attggtatat agtttaaaca aaacgaatga tttcgactca 10440 ttaaattatg ataatcatat ttaccaaatg cccctcattt acataaatat tatactagca 10500 tttaccatct cacttctagg aatactagta tatcgctcac acctcatatc ctccctacta 10560 tgcctagaag gaataatact atcgctgttc attatagcta ctctcacaac cctcaacacc 10620 cactccctct tagccaatat tgtgcctatt gccatactag tctttgccgc ctgcgaagca 10680 gcggtgggcc tagccctact agtctcaatc tccaacacat atggcctaga ctacgtacat 10740 aacctaaacc tactccaatg ctaaaactaa tcgtcccaac aattatatta ctaccactga 10800 catgactttc caaaaaacac ataatttgaa tcaacacaac cacccacagc ctaattatta 10860 gcatcatccc tctactattt tttaaccaaa tcaacaacaa cctatttagc tgttccccaa 10920 ccttttcctc cgacccccta acaacccccc tcctaatact aactacctga ctcctacccc 10980 tcacaatcat ggcaagccaa cgccacttat ccagtgaacc actatcacga aaaaaactct 11040 acctctctat actaatctcc ctacaaatct ccttaattat aacattcaca gccacagaac 11100 taatcatatt ttatatcttc ttcgaaacca cacttatccc caccttggct atcatcaccc 11160 gatgaggcaa ccagccagaa cgcctgaacg caggcacata cttcctattc tataccctag 11220 taggctccct tcccctactc atcgcactaa tttacactca caacacccta ggctcactaa 11280 acattctact actcactctc actgcccaag aactatcaaa ctcctgagcc aacaacttaa 11340 tatgactagc ttacacaata gcttttatag taaagatacc tctttacgga ctccacttat 11400 gactccctaa agcccatgtc gaagccccca tcgctgggtc aatagtactt gccgcagtac 11460 tcttaaaact aggcggctat ggtataatac gcctcacact cattctcaac cccctgacaa 11520 aacacatagc ctaccccttc cttgtactat ccctatgagg cataattata acaagctcca 11580 tctgcctacg acaaacagac ctaaaatcgc tcattgcata ctcttcaatc agccacatag 11640 ccctcgtagt aacagccatt ctcatccaaa ccccctgaag cttcaccggc gcagtcattc 11700 tcataatcgc ccacggactt acatcctcat tactattctg cctagcaaac tcaaactacg 11760 aacgcactca cagtcgcatc ataatcctct ctcaaggact tcaaactcta ctcccactaa 11820 tagctttttg atgacttcta gcaagcctcg ctaacctcgc cttacccccc actattaacc 11880 tactgggaga actctctgtg ctagtaacca cgttctcctg atcaaatatc actctcctac 11940 ttacaggact caacatacta gtcacagccc tatactccct ctacatattt accacaacac 12000 aatggggctc actcacccac cacattaaca acataaaacc ctcattcaca cgagaaaaca 12060 ccctcatgtt catacaccta tcccccattc tcctcctatc cctcaacccc gacatcatta 12120 ccgggttttc ctcttgtaaa tatagtttaa ccaaaacatc agattgtgaa tctgacaaca 12180 gaggcttacg accccttatt taccgagaaa gctcacaaga actgctaact catgccccca 12240 tgtctaacaa catggctttc tcaactttta aaggataaca gctatccatt ggtcttaggc 12300 cccaaaaatt ttggtgcaac tccaaataaa agtaataacc atgcacacta ctataaccac 12360 cctaaccctg acttccctaa ttccccccat ccttaccacc ctcattaacc ctaacaaaaa 12420 aaactcatac ccccattatg taaaatccat tgtcgcatcc acctttatta tcagtctctt 12480 ccccacaaca atattcatgt gcctagacca agaagttatt atctcgaact gacactgagc 12540 cacaacccaa acaacccagc tctccctaag cttcaaacta gactacttct ccataatatt 12600 catccctgta gcattgttcg ttacatggtc catcatagaa ttctcactgt gatatataaa 12660 ctcagaccca aacattaatc agttcttcaa atatctactc atcttcctaa ttaccatact 12720 aatcttagtt accgctaaca acctattcca actgttcatc ggctgagagg gcgtaggaat 12780 tatatccttc ttgctcatca gttgatgata cgcccgagca gatgccaaca cagcagccat 12840 tcaagcaatc ctatacaacc gtatcggcga tatcggtttt atcctcgcct tagcatgatt 12900 tatcctacac tccaactcat gagacccaca acaaatagcc cttctaaacg ctaatccaag 12960 cctcacccca ctactaggcc tcctcctagc agcagcaggc aaatcagccc aattaggtct 13020 ccacccctga ctcccctcag ccatagaagg ccccacccca gtctcagccc tactccactc 13080 aagcactata gttgtagcag gaatcttctt actcatccgc ttccaccccc tagcagaaaa 13140 tagcccacta atccaaactc taacactatg cttaggcgct atcaccactc tgttcgcagc 13200 agtctgcgcc cttacacaaa atgacatcaa aaaaatcgta gccttctcca cttcaagtca 13260 actaggactc ataatagtta caatcggcat caaccaacca cacctagcat tcctgcacat 13320 ctgtacccac gccttcttca aagccatact atttatgtgc tccgggtcca tcatccacaa 13380 ccttaacaat gaacaagata ttcgaaaaat aggaggacta ctcaaaacca tacctctcac 13440 ttcaacctcc ctcaccattg gcagcctagc attagcagga atacctttcc tcacaggttt 13500 ctactccaaa gaccacatca tcgaaaccgc aaacatatca tacacaaacg cctgagccct 13560 atctattact ctcatcgcta cctccctgac aagcgcctat agcactcgaa taattcttct 13620 caccctaaca ggtcaacctc gcttccccac ccttactaac attaacgaaa ataaccccac 13680 cctactaaac cccattaaac gcctggcagc cggaagccta ttcgcaggat ttctcattac 13740 taacaacatt tcccccacat cccccttcca aacaacaatc cccctctacc taaaactcac 13800 agccctcgct gtcactttcc taggacttct aacagcccta gacctcaact acctaaccaa 13860 caaacttaaa ataaaatccc cactatgcac attttatttc tccaacatac tcggattcta 13920 ccctaccatc acacaccgca caatccccta tctaggcctt cttacgagcc aaaacctgcc 13980 cctactcctc ctagacctaa cctgactaga aaagctatta cctaaaacaa tttcacagca 14040 ccaaatctcc acctccatca tcacctcaac ccaaaaaggc ataattaaac tttacttcct 14100 ctctttcttc ttcccactca tcctaaccct actcctaatc acataaccta ttcccccgag 14160 caatctcaat tacaatatat acaccaacaa acaatgttca accagtaact actactaatc 14220 aacgcccata atcatacaaa gcccccgcac caataggatc ctcccgaatc aaccctgacc 14280 cctctccttc ataaattatt cagcttccta cactattaaa gtttaccaca accaccaccc 14340 catcatactc tttcacccac agcaccaatc ctacctccat cgctaacccc actaaaacac 14400 tcaccaagac ctcaacccct gacccccatg cctcaggata ctcctcaata gccatcgctg 14460 tagtatatcc aaagacaacc atcattcccc ctaaataaat taaaaaaact attaaaccca 14520 tataacctcc cccaaaattc agaataataa cacacccgac cacaccgcta acaatcaata 14580 ctaaaccccc ataaatagga gaaggcttag aagaaaaccc cacaaacccc attactaaac 14640 ccacactcaa cagaaacaaa gcatacatca ttattctcgc acggactaca accacgacca 14700 atgatatgaa aaaccatcgt tgtatttcaa ctacaagaac accaatgacc ccaatacgca 14760 aaattaaccc cctaataaaa ttaattaacc actcattcat cgacctcccc accccatcca 14820 acatctccgc atgatgaaac ttcggctcac tccttggcgc ctgcctgatc ctccaaatca 14880 ccacaggact attcctagcc atgcactact caccagacgc ctcaaccgcc ttttcatcaa 14940 tcgcccacat cactcgagac gtaaattatg gctgaatcat ccgctacctt cacgccaatg 15000 gcgcctcaat attctttatc tgcctcttcc tacacatcgg gcgaggccta tattacggat 15060 catttctcta ctcagaaacc tgaaacatcg gcattatcct cctgcttgca actatagcaa 15120 cagccttcat aggctatgtc ctcccgtgag gccaaatatc attctgaggg gccacagtaa 15180 ttacaaactt actatccgcc atcccataca ttgggacaga cctagttcaa tgaatctgag 15240 gaggctactc agtagacagt cccaccctca cacgattctt tacctttcac ttcatcttgc 15300 ccttcattat tgcagcccta gcagcactcc acctcctatt cttgcacgaa acgggatcaa 15360 acaaccccct aggaatcacc tcccattccg ataaaatcac cttccaccct tactacacaa 15420 tcaaagacgc cctcggctta cttctcttcc ttctctcctt aatgacatta acactattct 15480 caccagacct cctaggcgac ccagacaatt ataccctagc caacccctta aacacccctc 15540 cccacatcaa gcccgaatga tatttcctat tcgcctacac aattctccga tccgtcccta 15600 acaaactagg aggcgtcctt gccctattac tatccatcct catcctagca ataatcccca 15660 tcctccatat atccaaacaa caaagcataa tatttcgccc actaagccaa tcactttatt 15720 gactcctagc cgcagacctc ctcattctaa cctgaatcgg aggacaacca gtaagctacc 15780 cttttaccat cattggacaa gtagcatccg tactatactt cacaacaatc ctaatcctaa 15840 taccaactat ctccctaatt gaaaacaaaa tactcaaatg ggcctgtcct tgtagtataa 15900 actaatacac cagtcttgta aaccggagat gaaaaccttt ttccaaggac aaatcagaga 15960 aaaagtcttt aactccacca ttagcaccca aagctaagat tctaatttaa actattctct 16020 gttctttcat ggggaagcag atttgggtac cacccaagta ttgactcacc catcaacaac 16080 cgctatgtat ttcgtacatt actgctagcc accatgaata ttgtacagta ccataaatac 16140 ttgaccacct gtagtacatg aaaacccaac ccacatcaaa accccctccc catgcttaca 16200 agcaagtaca gcaatcaacc ctcaactatc acacatcaac tgcaactcca aagccacccc 16260 tcacccacta ggataccaac aaacctaccc acccttaaca gcacatagta cataaagcca 16320 tttaccgtac atagcacatt acagtcaaat cccttctcgt ccccatggat gacccccctc 16380 agataggggt cccttgacca ccatcctccg tgaaatcaat atcccgcaca agagtgctac 16440 tctcctcgct ccgggcccat aacacttggg ggtagctaaa gtgaactgta tccgacatct 16500 ggttcctact tcagggccat aaagcctaaa tagcccacac gttcccctta aataagacat 16560 cacgatg 16567 19 23 DNA Homo sapiens 19 cccctacgca tttatataga gga 23 20 23 DNA Homo sapiens 20 cgtccaagtg cactttccag tac 23 21 18 DNA Homo sapiens 21 gaggagacaa gtcgtaac 18 22 17 DNA Homo sapiens 22 ttacgacttg cctcctc 17 23 20 DNA Homo sapiens 23 cccaccctac cacacattcg 20 24 19 DNA Homo sapiens 24 gggggttcga ttccttcct 19 25 18 DNA Homo sapiens 25 cttccttttt tgtctaga 18 26 17 DNA Homo sapiens 26 ttcctttttt ggctaga 17 27 264 DNA Cytomegalovirus 27 tttgttgtaa atggccgaga gaatggctga cgggtgatct ttgctgagtt ccttgaagac 60 ctctagggtg cgccgttgat ccacacacca ggcttctgcg atttgcgcca gcgcccggtt 120 gatgtaaccg cgcaacgtgt cataggtgaa ctgcagctgg gcgtagacca gattgtgcac 180 cgattccatg ctggacaaat gagttgtatt attgtcactc gtacttcttc tggtcctatg 240 agtgatattc agactggatc gatt 264 28 22 DNA Cytomegalovirus 28 tttgttgtaa atggccgaga ga 22 29 18 DNA Cytomegalovirus 29 caacggcgca ccctagag 18 30 18 DNA Cytomegalovirus 30 atcttgctga gttccttg 18 

I claim:
 1. A genetic screening method for detecting a cause of hereditary hearing loss, comprising: synthesizing a patient specimen amplicon, wherein said patient specimen amplicon comprises a section of a connexin 26 (Cx26) gene; immobilizing said patient specimen amplicon onto a substrate, thereby forming target DNA; and, allowing probes to hybridize with said target DNA, wherein said probes are selected from the group consisting of those sequences as set forth in SEQ ID NOS: 4, 5, 8, 9, 12, 13, 16, and 17, thereby forming a hybridized microarray slide specific for detecting mutations on said Cx26 gene.
 2. The method of claim 1, further comprising the step of scanning said hybridized microarray slide to produce data for detecting an extent of hybridization of said probes with said target DNA.
 3. The method of claim 2, wherein said data is color image data.
 4. The method of claim 2, wherein said data is a quantitative ratio of a wild type to mutant signal.
 5. The method of claim 1, wherein said patient specimen amplicon is synthesized from a dried blood spot on filter paper.
 6. The method of claim 1, wherein for the step of synthesizing said patient specimen amplicon, a primer selected from the group of those sequences as set forth in SEQ ID NO: 2, 6, 10, and 14 is used as a forward primer.
 7. The method of claim 1, wherein for the step of synthesizing said patient specimen amplicon, a primer selected from the group consisting of those sequences as set forth in SEQ ID NO: 3, 7, 11, and 15 is used as a reverse primer.
 8. A genetic screening method for detecting a cause of hereditary hearing loss, comprising: synthesizing a patient specimen amplicon, wherein said patient specimen amplicon comprises a section of a mitochondrial gene; immobilizing said patient specimen amplicon onto a substrate, thereby forming target DNA; and, allowing probes to hybridize with said target DNA, wherein said probes are selected from the group consisting of those sequences as set forth in SEQ ID NOS: 21, 22, 25, and 26, thereby forming a hybridized microarray slide specific for detecting mutations on said mitochondrial gene.
 9. The method of claim 8, further comprising the step of scanning said hybridized microarray slide to produce data for detecting an extent of hybridization of said probes with said target DNA.
 10. The method of claim 9, wherein said data is color image data.
 11. The method of claim 9, wherein said data is a quantitative ratio of a wild type to mutant signal.
 12. The method of claim 8, wherein said patient specimen amplicon is synthesized from a dried blood spot on filter paper.
 13. The method of claim 8, wherein for the step of synthesizing said patient specimen amplicon, a primer selected from the group of those sequences as set forth in SEQ ID NO: 19 and 23 is used as a forward primer.
 14. The method of claim 8, wherein for the step of synthesizing said patient specimen amplicon, a primer selected from the group consisting of those sequences as set forth in SEQ ID NO: 20 and 24 is used as a reverse primer.
 15. A genetic screening method for detecting a cause of hereditary hearing loss, comprising: synthesizing a patient specimen amplicon, wherein said patient specimen amplicon comprises a section of a cytomegalovirus (CMV) gene; immobilizing said patient specimen amplicon onto a substrate, thereby forming target DNA; and, allowing probes to hybridize with said target DNA, wherein said probe is that such sequence of SEQ ID NO: 30, thereby forming a hybridized microarray slide specific for detecting a presence of the CMV gene.
 16. The method of claim 15, further comprising the step of scanning said hybridized microarray slide to produce data for detecting an extent of hybridization of said probes with said target DNA.
 17. The method of claim 16, wherein said data is color image data.
 18. The method of claim 16, wherein said data is a quantitative ratio of a wild type to mutant signal.
 19. The method of claim 15, wherein said patient specimen amplicon is synthesized from a dried blood spot on filter paper.
 20. The method of claim 15, wherein for the step of synthesizing said patient specimen amplicon, a primer as set forth by SEQ ID NO: 28 is used as a forward primer.
 21. The method of claim 15, wherein for the step of synthesizing said patient specimen amplicon, a primer as set forth by SEQ ID NO: 29 is used as a reverse primer. 